Provider Demographics
NPI:1255654919
Name:SCHULTZ, HILLARY DAWN (LMT)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:DAWN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45107-9401
Mailing Address - Country:US
Mailing Address - Phone:937-783-4535
Mailing Address - Fax:937-783-5272
Practice Address - Street 1:160 ROBERTS LN STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7616
Practice Address - Country:US
Practice Address - Phone:937-393-2313
Practice Address - Fax:937-393-8933
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.014134171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor